Provider Demographics
NPI:1033675509
Name:WILLIAMSON, PEGGIE L (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:PEGGIE
Middle Name:L
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E FM 2410 RD STE D
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-6898
Mailing Address - Country:US
Mailing Address - Phone:254-394-2710
Mailing Address - Fax:254-442-0720
Practice Address - Street 1:1200 E FM 2410 RD STE D
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-6898
Practice Address - Country:US
Practice Address - Phone:254-394-2710
Practice Address - Fax:254-442-0720
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1315387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist